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1.4 Million Texans Fall Into ‘Coverage Gap’ Without Medicaid Expansion

Working Texans without job-based coverage comprise majority of those left behind.



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Like 23 other states, Texas chose not to expand Medicaid under the Affordable Care Act. Advocates have long argued this position will increase sickness and suffering. Now they’re pressing forward an economic argument.

In a new study, the group Families USA estimated that 1.4 million Texans would get coverage through Medicaid if the state changed its mind. Study author Dee Mahan says almost 60 percent of them are working, in occupations like sales, food service and transportation.

An additional twenty-four percent of the Texans in the so-called “coverage gap” are not in the workforce, because they are students, non-working spouses, or people with disabilities. Mahan said only 18 percent of those who would gain coverage are truly unemployed.

“We found that most of the people who’d be helped are working,” she said. “Such as waiters and waitresses in restaurants, construction workers, office clerks and cashiers. They include people who take care of our family members, like child care workers and personal care aides.”

Mahan says insuring those workers keeps them healthy and productive, and that helps their employers.

John Hawkins, senior vice president with the Texas Hospital Association, said his industry supports Medicaid expansion. He said Texas hospitals lose $5.5 billion annually on uncompensated care for the uninsured. Medicaid expansion would help cover some of those losses, but also be an economic stimulus for small businesses across Texas.

“Part of the economic miracle is the preponderance of small businesses in this service sector,” Hawkins said. “It’s really an economic engine – but it’s a sector of the economy where folks really struggle to obtain health coverage, either because their employer doesn’t offer it or because of the price, and it doesn’t really match up to their wages.”

If Texas did expand Medicaid, it could draw down tens of billions in federal money in federal funds over the next decade. And that money would create more healthcare jobs and could reduce the amount local governments pay to subsidize care for the uninsured.